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Exc benign tal 0.5 < cm 11400 at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$1,728.00
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$2,880.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$41.25 with UPMC Health Plan vs $2,448.00 with Humana — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $41.25 | ↓ -98% |
| United Healthcare Community Plan for Families | Unison Kids | $43.12 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $55.61 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $58.54 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $63.91 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $151.62 | ↓ -91% |
| Private Health Care Systems | Workers' Comp | $176.30 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $337.77 | ↓ -80% |
| UPMC Health Plan | Commercial | $481.38 | ↓ -72% |
| UPMC Health Plan | Managed Medicare | $623.37 | ↓ -64% |
| Health Plan of Upper Ohio Valley | Medicare | $670.79 | ↓ -61% |
| Health Plan of Upper Ohio Valley | Medicaid | $670.79 | ↓ -61% |
| United Healthcare | Unison Advantage Non Special Needs | $704.33 | ↓ -59% |
| Aetna of PA | Medicare | $704.33 | ↓ -59% |
| Highmark Wholecare (prev Gateway) | Medicare | $724.39 | ↓ -58% |
| AmeriHealth Caritas | Medicare | $724.45 | ↓ -58% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $724.45 | ↓ -58% |
| Aetna | Medicare | $737.87 | ↓ -57% |
| United Healthcare | Unison Advantage Special Needs | $737.87 | ↓ -57% |
| Highmark BCBS of PA | Managed Care - Social Mission | $752.04 | ↓ -56% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $937.49 | ↓ -46% |
| Cigna | New Business ASO | $979.20 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $1,007.19 | ↓ -42% |
| Cigna | Commercial | $1,152.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,255.57 | ↓ -27% |
| Health Plan of Upper Ohio Valley | Commercial | $1,330.56 | ↓ -23% |
| Highmark BCBS of PA | UPMC Emergent | $2,014.38 | ↑ +17% |
| Coventry/First Health | Commercial | $2,016.00 | ↑ +17% |
| InterGroup | PPO | $2,390.40 | ↑ +38% |
| Private Health Care Systems | PPO | $2,448.00 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $2,448.00 | ↑ +42% |
| Humana | Commercial | $2,448.00 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc benign tal 0.5 < cm 11400 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $1,527.60 | $41.25 – $2,291.40 |
| UPMC Presbyterian | Pittsburgh | $3,265.20 | $41.25 – $4,625.70 |
| UPMC St. Margaret | Pittsburgh | $1,703.40 | $41.25 – $2,413.15 |
| UPMC Muncy | Muncy | $1,440.00 | $41.25 – $1,920.00 |
| UPMC Somerset | Somerset | $1,341.60 | $41.25 – $1,135.50 |
| UPMC Wellsboro | Wellsboro | $1,741.60 | $41.25 – $993.28 |
| UPMC Williamsport | Williamsport | $490.80 | $41.25 – $993.28 |
| UPMC Northwest | Seneca | not published | $41.25 – $704.33 |